Individual provider Active NPI

Amy Virginia Wiegand, MS

  • Genetic Counselor (M.S.)
  • New Haven, CT
National Provider Identifier
1821686403
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
License
168 Issued in CT
Practice address
330 Orchard St Ste 107
New Haven, CT 06511-4430
Phone
(203) 200-4362
Fax
(203) 200-1362
NPI assigned
Jan 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X GC00189 RI
Genetic Counselor (M.S.) 170300000X 168 CT Primary

Addresses

Primary practice location

330 Orchard St Ste 107
New Haven, CT 06511-4430

Mailing address

19 Appalachian E
Hopewell Junction, NY 12533-6709
Phone (203) 885-5996

Other names 1

  • Amy Virginia Killie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
168CTMDBehavioral Analyst
GC00189RIMDGenetic Counselor (M.S.)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1821686403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 APPALACHIAN E",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125336709",
            "telephone_number": "203-885-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ORCHARD ST STE 107",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114430",
            "telephone_number": "203-200-4362",
            "fax_number": "203-200-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGAND",
        "first_name": "AMY",
        "middle_name": "VIRGINIA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "RI",
            "license": "GC00189",
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "CT",
            "license": "168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "KILLIE",
            "middle_name": "VIRGINIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.